Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Cervical Cancer”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 559 records · Page 31Linked to original sources
PubMed2004

Persistent area socioeconomic disparities in U.S. incidence of cervical cancer, mortality, stage, and survival, 1975-2000.

BACKGROUND: Temporal cervical cancer incidence and mortality patterns and ethnic disparities in patient survival and stage at diagnosis in relation to socioeconomic deprivation measures have not been well studied in the United States. The current article analyzed temporal area socioeconomic inequalities in U.S. cervical cancer incidence, mortality, stage, and survival. METHODS: County and census tract poverty and education variables from the 1990 census were linked to U.S. mortality and Surveillance, Epidemiology, and End Results cancer incidence data from 1975 to 2000. Age-adjusted incidence and mortality rates and 5-year cause-specific survival rates were calculated for each socioeconomic group and differences in rates were tested for statistical significance at the 0.05 level. RESULTS: Substantial area socioeconomic gradients in both incidence and mortality were observed, with inequalities in cervical cancer persisting against a backdrop of declining rates. Cervical cancer incidence and mortality rates increased with increasing poverty and decreasing education levels for the total population as well as for non-Hispanic white, black, American Indian, Asian/Pacific Islander, and Hispanic women. Patients in lower socioeconomic census tracts had significantly higher rates of late-stage cancer diagnosis and lower rates of cancer survival. Even after controlling for stage, significant differences in survival remained. The 5-year survival rate among women diagnosed with distant-stage cervical cancer was approximately 30% lower in low than in high socioeconomic census tracts. CONCLUSIONS: Census-based socioeconomic measures such as area poverty and education levels could serve as important surveillance tools for monitoring temporal trends in cancer-related health inequalities and targeting interventions.

Education↗
PubMed1989

Sensitivity of the screening program for cervical cancer in the Florence District.

Cervical cancer screening has been ongoing in the Florence district since 1966. All invasive cervical cancers occurring from 1975 to 1985 in the district have been considered and their screening histories have been investigated to estimate screening sensitivity. In the years 1975-1984, 236,045 women were screened initially. In this population all interval cancers have been recorded to estimate first screening sensitivity values according to the length of the interval since the first Pap test: 0.90 at 1 year, 0.78 at 3 years, and 0.68 at 5 years. Sensitivity values for subsequent screenings were lower than those for the first screening (0.68 at 1 year, 0.43 at 3 years), probably due to a lower number of prevalent cancers and to a progressive selection of cancers which are difficult to detect. The high sensitivity values confirm our choice of a screening frequency of 3 years.

Adolescent↗
PubMed1995

The use of operative laparoscopy in determining eligibility for pelvic exenteration in patients with recurrent cervical cancer.

In patients with suspected recurrent cervical cancer after radiation therapy, it can be very difficult to pathologically confirm recurrence and clinically determine if tumor is resectable via a curative pelvic exenteration. Despite very thorough preoperative investigation uncertainties often remain, so patients ultimately undergo exploratory laparotomy. Unfortunately, inoperable disease is frequently discovered then. We report the use of operative laparoscopy in three patients with recurrent stage IIIB cervical cancer. The age ranged from 38 to 79 years. The mean duration of the procedure was 146 min (range 110-180 min) and blood loss was minimal. The procedure was well tolerated in all patients. There was no intraoperative complication but one deep thrombophlebitis occurred postoperatively. The procedure was successful in all cases in confirming recurrence and selecting out patients who were not surgical candidates for pelvic exenterations. Operative laparoscopy is a less invasive procedure that may be a valuable step in the workup of patients with recurrent cervical cancer. With experience in retroperitoneal surgery, the procedure can be carried out safely. We believe that this approach could prevent unnecessary laparotomies, shorten the hospital stay and the postoperative recovery, and contribute to a better quality of life for women with inoperable disease.

Adult↗
PubMed2003

[Value of acetic acid smear test for cervical cancer screening].

BACKGROUND & OBJECTIVE: At present, the incidence of cervical cancer is still high in less developed areas of China; one of the reasons is that cytology in screening for cervical cancer is not feasible in these areas. The aim of this study was to analyze the sensitivity and specificity of acetic acid smear test as a cervical cancer screening test, and evaluate the value of this method for cervical cancer screening. METHODS: Acetic acid smear test was performed on 1997 previously unscreened women aged 35-45 years in Xiangyuan County, Shanxi Province. All women had cervical cytology, testing for high-risk types of human papillomavirus DNA, colposcopy, an endocervical curettage and at least five cervical biopsies. Biopsies were done at the lesions, or one biopsy at 2, 4, 8, 10 o'clock at the squamocolumnar junction in each normal quadrant. RESULTS: According to histological diagnosis, 43 women had CIN II, 31 had CIN III, and 12 had invasive carcinoma. In two women only the endocervix was positive. Smear test yielded normal results in 1445 women (72.4%), low-grade squamous intraepithelial lesions (LSILs, CIN I) in 525 (26.3%), high-grade squamous intraepithelial lesions (HSILs, CIN II- III) in 21 (1.1%), and cancer in 6 (0.3%). With abnormal visual inspection defined as LSILs or worse, the sensitivity of acetic acid smear test for HSILs or worse was 70.9% (61 of 86), the specificity was 74.3% (1420 of 1911). The sensitivity was 64.9% for smaller lesions (37 of 57), and 88.9% for larger lesions (24 of 27) (P=0.03). The sensitivity of colposcopy for high-grade SILs or worse was 81.4% (70 of 86), the specificity was 76.5% (1462 of 1911). CONCLUSION: This study showed the high specificity and sensitivity of acetic acid smear test as a primary screening test for cervical cancer. Acetic acid smear test and colposcopy have similar specificity profiles for CIN II or more severe lesions. Acetic acid smear test as a primary screening test will be possible and effective with the benefits of low-cost and simple test in low-resource settings.

Acetic Acid↗
PubMed2002

A slow acetylator genotype associated with an increased risk of advanced cervical cancer.

PURPOSE: Human papillomavirus (HPV) is the major etiological agent associated with cervical cancer. However, other risk factors have been indicated, including carcinogen exposure, oral contraceptive usage, certain nutritional deficiencies, and genetic factors. N-acetyltransferase 2 (NAT2) has an important role in the metabolism of several carcinogens. NAT2 polymorphism modulates the activity of the enzyme, by activation, via O-acetylation, or through detoxification, via N-acetylation. This case-control study was designed to evaluate the association between NAT2 polymorphism and genetic susceptibility to cervical cancer. METHODS: Genomic DNA was obtained from 125 women with advanced cervical cancer and 170 healthy women. PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphisms) was used to analyse two common mutant alleles at NAT2 loci. RESULTS: The NAT2*6/NAT2*6 genotype, which corresponds to a slow acetylator genotype, was found to be associated with a 3.41-fold (95% CI: 1.35-8.94; P= 0.007) increase in the risk of cervical cancer. For the entire case groups the proportion of cervical cancer cases attributable (attributable proportion) to the NAT2*6/NAT2*6 genotype was 10.2%. CONCLUSIONS: The results reported in this study suggest that NAT2 polymorphism is a genetic susceptibility factor involved in the carcinogenesis of cervical cancer, and also that the analysis of the allelic profile of populations in different geographic locations may help to understand the incidence of cervical cancer worldwide.

Acetylation↗
PubMedDate not supplied

Annual productivity costs due to cervical cancer mortality in the United States.

BACKGROUND: Several studies have estimated annual US health care costs associated with cervical cancer; however, few data are available on the corresponding annual loss in women's productive earnings resulting from premature mortality owing to cervical cancer. The present study estimates annual productivity costs associated with cervical cancer mortality in the United States. METHODS: An analytic framework was developed for estimating the lost earnings that would have accrued during 2000 for women dying from cervical cancer during that and earlier years, who would have otherwise been alive and working in 2000. The following data from publicly available sources were gathered and analyzed for US women on an age-specific basis: 1) annual number of cervical cancer deaths during 2000 and preceding years; 2) estimated probability of otherwise being alive during 2000, for women dying from cervical cancer during the period 1935-2000; 3) labor force participation rates in 2000; and 4) mean annual earnings in 2000. RESULTS: Overall, it was estimated that there were 130,377 women who would have been alive during 2000 had they not died from cervical cancer during that or a previous year. Over 75% of these women died before age 60, with >25% dying prior to age 40, and it was estimated that 37,594 (29%) of these women would have had labor force earnings during 2000. The total productivity loss in 2000 owing to cervical cancer mortality was estimated at $1.3 billion. CONCLUSIONS: The annual productivity loss for cervical cancer estimated in the present analysis is several times higher than recent estimates of the annual US direct medical costs associated with cervical cancer ($300-$400 million).

Adult↗
PubMed2006

Serum levels of insulin-like growth factor-I and -II and insulin-like growth factor binding protein 3 in women with squamous intraepithelial lesions and cervical cancer.

INTRODUCTION: Pap smear has limitations as a screening test for cervical cancer. A marker that allows the identification of women who are at risk of developing cervical cancer would be useful for its prevention. A growing number of studies have demonstrated an association between insulin-like growth factors (IGF) serum levels and increased risk for various cancers. Objective. To assess whether circulating IGF-I, IGF-II, or IGF binding protein 3 (IGFBP-3) were associated with cervical cancer and low-grade and high-grade squamous intraepithelial lesions (LSIL and HSIL). MATERIALS AND METHODS: Serum levels of IGF-I, IGF-II and IGFBP-3 were measured by ELISA. Three groups of cases were analyzed: LSIL (n = 37), HSIL (n = 57), and cervical cancer (n = 41). For each case, two controls, matched by age, were included. Control subjects were women with normal, HPV-DNA-negative Pap smear. RESULTS: Significantly lower values of IGF-I (83.9 ng/ml versus 126.6 ng/ml, p < 0.001) and IGF-I:IGFBP-3 molar ratio (0.094 versus 0.137, p < 0.001) were observed among cancer cases, as compared to their control group. Women in the highest quartile of IGF-I and IGF-I:IGFBP-3 molar ratio were at an 80% (OR = 0.2, 95% CI [0.06-0.61]) and a 77% (OR = 0.23, 95% CI [0.07-0.73]) lower risk of cervical cancer, respectively, compared with women in the corresponding reference category. CONCLUSIONS: These data suggest that low values of IGF-I and IGF-I:IGFBP-3 molar ratio may be associated with cervical cancer.

Adult↗
PubMed2000

Cervical cancer screening in Italy.

Until recently cervical cancer screening in Italy has been mainly spontaneous, with only a few organised programmes. This resulted in low coverage and high frequency of tests in screened women (mostly every year). The situation is, however, rapidly changing. In 1996 nationwide organised programmes, on a regional basis, were recommended. National guidelines recommend personal invitation of women aged 25-64 years for a Pap-test every third year. At the end of 1999 34% of the Italian population 25-64 years old was included in organised programmes. Most organised programmes have fail-safe systems for women referred for colposcopy, protocols for diagnostic work-up and treatment and reference centres for such phases, according to the recommendations of national and European guidelines. However the size of laboratories is frequently smaller than recommended. Most organised programmes implement quality assurance processes for cytology interpretation, that have been intensive in some centre, but there is no nationwide standardisation. In recent years data for monitoring screening activity have been collected in a standardised way by most organised programmes, in the framework of GISCi (Italian Group for Cervical Cancer Screening) allowing internal and external comparisons. In some cases strong improvements of coverage after the introduction of an organised activity have been documented. Data, however, suggest a relevant heterogeneity of criteria for cytology interpretation, requiring actions to increase consistency. The impact of these transformations on incidence of cervical cancer will be observed in the future: preliminary results suggest a reduction in older programmes.

Adult↗
PubMed2005

Cervical cancer in women with comprehensive health care access: attributable factors in the screening process.

BACKGROUND: Invasive cervical cancer is highly preventable, yet it continues to occur, even among women who have access to cancer screening and treatment services. To reduce cervical cancer among such women, reasons for its occurrence must be better understood. We examined factors associated with the diagnosis of cervical cancer among women enrolled in health plans. METHODS: We identified all cases of invasive cervical cancer (n = 833) diagnosed from January 1, 1995, through December 31, 2000, among women who were long-term members of seven prepaid comprehensive health plans and reviewed each woman's medical records for the 3 years prior to her cancer diagnosis. Women were classified into one of three categories based on Pap test histories 4-36 months before diagnosis: failure to screen with a Pap test, failure in detection by a Pap test, or failure in follow-up of an abnormal test result. RESULTS: The majority of cases (n = 464; 56%) were in women who had no Pap tests during the period 4-36 months prior to diagnosis. Of the remaining cases, 263 (32%) were attributed to Pap test detection failure and 106 (13%) to follow-up failure. Being older (odds ratio [OR] = 6.48, 95% confidence interval [CI] = 3.89 to 10.79) or living in an area of higher poverty (OR = 1.72, 95% CI = 1.11 to 2.67) or having a lower education level (OR= 1.52; 95% CI = 1.07 to 2.16) was associated with the likelihood of being assigned to the failure to screen category versus either of the other two categories. A total of 375 (81%) of the 464 patients who had not had Pap screening had had at least one outpatient visit 4-36 months prior to cancer diagnosis. The cancer diagnostic process was triggered by a routine screening examination in 44% of patients, whereas 53% of the patients presented with symptoms consistent with cervical cancer; the remaining 3% were identified fortuitously during the course of receiving noncervical care. CONCLUSIONS: To reduce the incidence of invasive cervical cancer among women with access to screening and treatment, Pap screening adherence should be increased. In addition, strategies to improve the accuracy of Pap screening could afford earlier detection of cervical cancer.

Adult↗
PubMed2006

HPV viral load determination during pregnancy as a possible cervical cancer risk.

Pregnancy may be a risk factor for cervical human papillomavirus (HPV) infection due to associated increased hormonal level and immunosuppression. Although a majority of such infections are transient, persistent infection may lead to premalignant/malignant cervical lesion. The viral burden is thought to be an indicator for persistence of the infection and malignant transformation. To assess pregnancy as a risk factor for cervical HPV infection, we compared HPV prevalence and viral load among 25 pregnant women to those of 24 non-pregnant and 28 cervical cancer cases. HPV DNA was detected in the cervical cells by PCR using MY09/MY11 primers. HPV positive cases were retested with a low stringency PCR method to ascertain the viral load. HPV prevalences of 68%, 25% and 89% were observed among pregnant women, non-pregnant women and in the cervical cancer cases, respectively. High viral load was frequently (40%) observed in cervical cancer patients. Median viral copy number/cell did not vary much between the non-pregnant and pregnant women. However, pregnant women had a predominantly moderate viral load whereas the low viral load was more frequent in non-pregnant women. High viral load was found to be associated with the presence of HPV 16 in the cervical cancer cases as compared to pregnant/non-pregnant HPV infected women.

Adult↗
PubMed1981

The relationship of cervical cytology to the incidence of invasive cervical cancer and mortality in Alameda County, California, 1960 to 1974.

Cervical cytology as an examination procedure is nearly ideal for discovering unsuspected cervical epithelial malignant changes. A large proportion of women is now being examined periodically with this procedure, and the question now is what effect has this had on the occurrence of invasive cervical cancer and deaths from this disease. Data are available on invasive cervical cancer and its mortality in Alameda County, California, for the 15 years, 1960-1974. Population survey data are available on the experience of women in the County with cervical cytology in 1962 and again in 1973-1974. All cases diagnosed in 1971-1975 were reviewed for a history of cytologic examinations in the 5 years prior to diagnosis. There has been a reduction of over 40% in the occurrence of invasive cervical cancer and mortality among white women in the 10 years 1960-1964 versus 1970-1974. There has been a lesser reduction in both among black women. Twenty-nine percent of women who developed invasive cervical cancer during 1970-1974 had a history of recent negative cytology. This finding indicates that not all invasive cervical cancers have a prolonged in situ stage.

Adolescent↗
PubMed1996

Overexpression of the insulin-like growth factor-1 receptor and autocrine stimulation in human cervical cancer cells.

We characterized mechanisms of growth control involving insulin-like growth factor-1 (IGF-1), IGF-2, and IGF-1 receptor (IGF-1R) by investigating their expression in human cervical cancer cell lines, primary cervical tumor cell cultures, and normal ectocervical epithelial cells maintained in short-term culture. By reverse transcription followed by PCR, IGF-1 mRNA was not detected in any of the cell lines, whereas IGF-2 mRNA transcripts were detected in all of them. Using the RNase protection assay, low levels of IGF-2 mRNA were also detected in all of the cervical cancer cell lines, primary cervical tumor cell cultures, and normal ectocervical cultures tested, but no IGF-1 transcripts were detected. Scatchard analysis revealed 3- and 5-fold increases in IGF-1R expression by the primary cervical cancer cell cultures and cervical cancer cell lines, respectively, compared with the normal ectocervical cells. In proliferation assays, epidermal growth factor (EGF) consistently enhanced cervical cancer cell growth, but an antisense oligonucleotide to IGF-2 uniformly inhibited the EGF-induced mitogenic effect. These studies suggest that autocrine production of IGF-2 and overexpression of the IGF-1R are important components controlling the proliferation of cervical carcinoma cells, and that autocrine IGF-2 production in cervical cancer cells may participate in the mitogenic signaling of EGF.

Base Sequence↗
PubMed2002

Costs and benefits of different strategies to screen for cervical cancer in less-developed countries.

BACKGROUND: About 80% of cervical cancers occur in less-developed countries. This disproportionate burden of cervical cancer in such countries is due mainly to the lack of well-organized screening programs. Several cervical cancer screening strategies have been proposed as more cost-effective than cytology screening. We compared the costs and benefits of different strategies and their effectiveness in saving lives in a less-developed country. METHODS: We used a population-based simulation model to evaluate the incremental societal costs and benefits in Thailand of seven screening techniques, including visual inspection of the cervix after applying acetic acid (VIA), human papillomavirus (HPV) testing, Pap smear, and combinations of screening tests, and examined the discounted costs per year of life saved (LYS). RESULTS: Compared with no (i.e., not well-organized) screening, all strategies saved lives, at costs ranging from 121 US dollars to 6720 US dollars per LYS, and reduced mortality, by up to 58%. Comparing each strategy with the next least expensive alternative, VIA performed at 5-year intervals in women of ages 35-55 with immediate treatment if abnormalities are found was the least expensive option and saved the greatest number of lives, with a cost of 517 US dollars per LYS. HPV screening resulted in similar costs and benefits, if the test cost is 5 US dollars and if 90% of women undergo follow-up after an abnormal screen. Cytology (Pap smear) was a reasonable alternative if sensitivity exceeds 80% and if 90% of women undergo follow-up. Compared with no screening, use of a combination of Pap smear and HPV testing at 5-year intervals in women of ages 20-70 could achieve greater than 90% reduction in cervical cancer mortality at a cost of 1683 US dollars per LYS, and VIA could achieve 83% reduction at 524 US dollars per LYS. CONCLUSIONS: Well-organized screening programs can reduce cervical cancer mortality in less-developed countries at low costs. These cost-effectiveness data can enhance decision-making about optimal policies for a given setting.

Acetic Acid↗
PubMed2003

Screening interval and risk of invasive squamous cell cervical cancer.

To compare the risks of developing invasive squamous cell cervical cancer associated with screening intervals of 1, 2, and 3 years after a negative cervical smear. We conducted a matched case-control study of invasive squamous cell cervical cancer patients (n = 482) diagnosed between 1983 and 1995 among long-term members of a large health maintenance organization. Controls were matched for age, length of membership, and race (n = 934). Screening interval was time between the last negative cervical smear and the case diagnosis date. The main outcome measure was the relative odds of invasive disease associated with 1-year, 2-year, and 3-year intervals. The odds ratio for a 2-year versus a 1-year interval was 1.72 (95% confidence interval 1.12, 2.64, P =.013) and for a 3-year versus a 1-year interval was 2.06 (95% confidence interval 1.21, 3.50, P =.007). The odds ratio for a 3-year versus a 2-year interval was 1.20 (95% confidence interval 0.65, 2.21, P =.561). Controlling for ever having had an abnormal cervical smear or a previous consecutive negative smear did not substantially change these results. In this large health plan, the relative risks of invasive squamous cell cervical cancer were significantly greater for 2-year and 3-year cervical cancer screening intervals compared with a 1-year interval, but not for a 3-year interval compared with a 2-year interval. Our findings need to be placed in the context of the low absolute risks of developing invasive cervical cancer during the first 3 years after a negative cervical smear before making policy recommendation.

Adult↗
PubMed2003

Meta-analysis of social inequality and the risk of cervical cancer.

Previous studies of the relationship between socio-economic status and cervical cancer have been mainly based on record linkage of routine data, such as cancer registry incidence rates and regional measures of social class based on census data. These routine data are liable to substantial misclassification with respect to socio-economic status. Previous reports are also primarily from developed countries, whereas the major burden of cervical cancer is in developing countries. We have therefore pooled the data from previously reported case-control studies of cervical cancer or dysplasia, which contain individual-level information on socio-economic characteristics to investigate the relationship between cervical cancer, social class, stage of disease, geographical region, age and histological type. Based on 57 studies, we found an increased risk of approximately 100% between high and low social class categories for the development of invasive cervical cancer, and an increased risk of approximately 60% for dysplasia, including carcinoma in situ. Although the difference was observed in all countries, it was stronger in low/middle income countries and in North America than in Europe. No clear differences were observed between squamous cell carcinoma and adenocarcinoma, or between younger and older women. These results indicate that both cervical infection with human papillomavirus, which is linked to both female and male sexual behaviour, and access to adequate cervical cancer screening programmes are likely to be important in explaining the large cervical cancer incidence rates observed in different socio-economic groups, and that the importance of these factors may vary between different geographical regions.

Adult↗
PubMed2004

Risk factors for cervical cancer development: what do women think?

BACKGROUND: The current cervical cancer prevention strategy is exclusively directed towards screening, without taking into account any relationship with sexual risk factors. The introduction of human papillomavirus (HPV) detection into the screening procedure implicates that we should give attention to this relationship. The aim of this study was to investigate what knowledge women have of the relation between HPV and cervical cancer. METHODS: Rather than asking about HPV specifically, we suggested 20 risk factors for the development of cervical cancer, including viral infection, and asked 73 women visiting their general practitioner, 67 women visiting a lecture on risk factors for cervical cancer and 28 female students in biomedical sciences to rate the importance of these risk factors on a scale of 1-5. RESULTS: Genetic factors were rated highest with a mean score of 4.5. Bacterial infection ranked second highest with a mean score of 3.8. Smoking ranked fourth at a mean score of 3.6, whereas viral infection shared the sixth place with number of sexual partners with a mean score of 3.4. The presence of high voltage power lines and physical activity appropriately scored the last two places at 2.4 and 2.2, respectively. Twenty-one women suggested a role for sexually transmitted agents, but only five women (3.1%) could actually pinpoint HPV. CONCLUSION: This enquiry indicates that the risk factor 'genetic factors' was over-rated, while knowledge of the most important risk factors, i.e. smoking and sexual habits and (sexually transmitted) infections, would appear to be present to a moderate level in our population. However, knowledge of the role of HPV in cervical cancer development is lacking.

Adult↗
PubMed2000

Cervical cancer screening in Sweden.

Organised cervical cancer screening was implemented in Sweden in the mid-1960s. A marked decline in cervical cancer incidence could be attributed to the time-point of start of screening. Squamous cell carcinoma has declined by 60%, whereas adenocarcinoma has increased. About 950000 papanicolaou (Pap) smears are taken annually. Only 31% of the smears taken in the organised screening programme. As of 1998, the screening guidelines are 3-yearly tests between 23 and 50 years of age and 5-yearly tests between 50 and 60 years of age. The article reviews the screening practise in Sweden, the current efforts to improve the quality of the screening programme, as well as the ongoing randomised evaluations of organised primary screening for cervical human papilloma virus (HPV) infection.

Adult↗
PubMed2005

[Analysis on synergistic action between estrogen, progesterone and human papillomaviruses in cervical cancer].

OBJECTIVE: To explore the effects of estrogen (E(2)) and progesterone (P) on cervical cancer and the synergistic action between estrogen, progesterone and human papillomaviruses (HPV). METHODS: Hoted-start polymerase chain reaction (HS-PCR) was used to detect HPVs, HPV16 and ELISA was used to assay E(2) and P on 141 cases with cervical cancer and on 129 healthy controls. RESULTS: Positive rates of HPVs and HPV16 were 75.2% and 46.8% respectively in cervical cancer group, significantly higher than that in controls. Levels of estrogen and progesterone in case group were significantly higher than that in controls and a dose-responded relationship between the levels of estrogen and cervical cancer was revealed. Estrogen and HPV showed an additive interaction in the development of cervical cancer. CONCLUSION: HPV16 infection played a principal role in the development of cervical cancer. The high levels of entogenous estrogen could increase the risk of cervical cancer and might serve as a cofactor in the development of HPV-induced cervical cancer.

Adult↗